Nigeria Brought Child Mortality Way Down. But Another Crisis Looms

Nigeria Brought Child Mortality Way Down. But Another Crisis Looms

A group of girls sell food at Malkohi refugee camp in Jimeta, Adamawa State, Nigeria.

SourceLUIS TATO/AFP/Getty

Why you should care

It’s a blockbuster economy in Africa, but developmental disabilities are soaring in its younger generation.

It is a bright morning in Lagos, Nigeria. Babatunde Ogunmefun, 24, limps around the soccer pitch, chasing the ball, hands firmly gripping his crutches. When he heaves his single leg forward to kick the ball, he staggers and smiles before regaining his balance.

“From childhood I always loved football,” he says. But that happiness evaporates once he steps off the pitch, where he often gets bullied and isolated. Babatunde wasn’t born with his disability — his foot was crushed in an accident at the age of 5 — but his experience is typical of those whose childhoods are marked by developmental disabilities in Nigeria. And their ranks are growing.

In Nigeria, developmental disability diagnoses in children have soared nearly 80 percent since 1990.

Globally, an estimated 53 million children under the age of 5 suffer from developmental disabilities — defined as a severe, chronic disability originating at birth or in childhood, one that restricts sufferers from participating in normal life — according to a study released in late 2018 by the Bill & Melinda Gates Foundation. Worldwide, diagnoses have dipped slightly, though they’ve gone up in some individual countries. In the U.S., the increase between 1990 and 2016 was 5.61 percent. While India and China have far more developmental disability diagnoses than Nigeria — 11 million and 4 million respectively, compared to Nigeria’s 2.5 million — cases in India went down slightly and in China they dropped by nearly half. Common developmental disabilities include loss of hearing or vision, autism spectrum disorder, Down’s syndrome, cerebral palsy, learning disorders and epilepsy.

Nigeria didn’t have the steepest rise in the world in disability diagnoses: Afghanistan went up 92 percent, Iraq rose 123 percent and Palestine was up 167 percent. But these are war-torn nations, and Nigeria is now the largest economy in Africa. Nonetheless, far from recognizing the rising diagnoses as a national crisis, the country — fueled by social stigmas and cultural traditions — is by and large neglecting the issue.

“People believe that the parents of such children are cursed. That the situation with the child could be some atonement for some sort of evil deed. And when the child begins to go out, the stigma now turns to him too,” says Dr. Muideen Bakare of Childhood Neuropsychiatric Disorders Initiatives.

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A boy covers himself with a plastic bag while All Progressives Congress party (APC) supporters celebrate initial results released two days after general elections last month.

Source LUIS TATO/AFP/Getty

During elections, politicians vying for office often make very public donations to disabled people or to orphanages catering to children with disabilities. But while such gifts can provide temporary relief, there is no effective government institution providing lasting relief and support. At best, children with developmental disabilities turn to private institutions and services tailored to their needs and limitations. But because such services or institutions are expensive, only a few can actually access it.

Last year, Nigeria enacted the Discrimination against Persons with Disabilities (Prohibition) Act, providing a legal framework to halt discrimination against people with disabilities — more or less the adult version of the Child Rights Act adopted in 2003. Still, David Anyaele, of Nigerian nonprofit Centre for Citizens with Disabilities, names a lack of political will to implement existing laws as the biggest setback for Nigeria’s disabled population.

The country’s limitations aren’t the only thing that may be holding it back. Dr. Olusanya Bolajoko, a lead researcher for the study, says that global influence of foreign aid funding sometimes weakens the ability of developing nations like Nigeria to create a locally tailored approach to managing disabilities. That means the public health priorities necessary to gain funding from outside don’t necessarily match up with the problems actually facing Nigeria.

But the rise of developmental disability diagnoses in Nigeria isn’t all bad news. Some of it can be explained by population growth: The population of Nigeria nearly doubled between 1990 and 2016 — but India’s zoomed up 52 percent in the same period and it saw no such rise in diagnoses. Olusanya says the explosion of developmental disability diagnoses can be read as a positive sign that children with potentially fatal conditions are surviving them. And Nigeria’s under-5 mortality rate has indeed plunged, according to UNICEF, down 52 percent from 1990-2017.

For disability advocates, it’s a question of how Nigeria provides — or, largely, doesn’t — for the kids who are now living past childhood. According to the World Report on Disability 2011, 12 percent of Nigerians have at least one disability. But more than half of the 13 million children in Nigeria who don’t attend school have special needs, largely because the schools are unable to accommodate them. That leaves kids with disabilities at a huge educational disadvantage. By comparison, an estimated 1.2 million British children have special educational needs, and about 4,500 were either awaiting suitable education placement or were homeschooled as of 2018.

Bakare says awareness, social support and improved rural health care are key to resolving the disability crisis in Nigeria. Many pregnant mothers in rural communities have limited access to antenatal support, he explains, meaning they don’t have any warning that their baby may require special care. Those support structures will be crucial to Nigeria’s ability to support its younger generation and their needs. Anyaele says he’s optimistic that the nation can make that progress. “But,” he says, “that will only happen when the government begins to see issues related to disability as a state responsibility and not a gesture of some personally motivated kindness.”

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